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Volume 27, Number 3—March 2021
Dispatch

Lung Pathology of Mutually Exclusive Co-infection with SARS-CoV-2 and Streptococcus pneumoniae

Tetsuya Tsukamoto1, Noriko Nakajima1, Aki Sakurai1, Masayuki Nakajima, Eiko Sakurai, Yuko Sato, Kenta Takahashi, Takayuki Kanno, Michiko Kataoka, Harutaka Katano, Mitsunaga Iwata, Yohei Doi, and Tadaki SuzukiComments to Author 
Author affiliations: Fujita Health University School of Medicine, Toyoake, Japan (T. Tsukamoto, A. Sakurai, M. Nakajima, E. Sakurai, M. Iwata, Y. Doi); National Institute of Infectious Diseases, Tokyo, Japan (N. Nakajima, Y. Sato, K. Takahashi, T. Kanno, M. Kataoka, H. Katano, T. Suzuki)

Main Article

Table

Quantification of SARS-CoV-2 RNA and Streptococcus pneumoniae DNA in 42 lung sections from a patient in Japan co-infected with both pathogens*

Lung lobe Lung section SARS-CoV-2 RNA, copies/μL GAPDH mRNA, copies/μL SARS-CoV-2 RNA/GAPDH mRNA ratio SARS-CoV-2 RNA score† S. pneumoniae DNA, copies/μL ACTB DNA, copies/μL S. pneumoniae DNA/ACTB DNA ratio × 105 S. pneumoniae DNA score‡
RUL
 R1§ 2.01 × 106 1.31 × 103 1,534 3 1.67 × 102 5.66 × 104 295 2
R2 1.71 × 106 1.03 × 103 1,660 3 2.01 × 102 8.24 × 104 244 2
R3 6.66 × 105 1.66 × 103 401 2 4.17 × 101 3.40 × 104 123 2
R4 6.93 × 105 1.70 × 103 408 2 5.36 × 101 4.58 × 104 117 2
R5 6.87 × 105 1.80 × 103 382 2 2.48 × 101 7.39 × 104 34 1
R6 1.98 × 105 1.21 × 103 164 2 9.07 × 101 1.33 × 105 68 1
R7 8.98 × 105 1.65 × 103 544 2 5.24 × 101 1.02 × 105 51 1
R8
 5.48 × 105
 8.66 × 102
 633
 2
 UDL
 1.07 × 105
 UDL
 0
RLL
 R9 7.50 × 105 8.82 × 102 850 2 2.10 × 102 7.33 × 104 286 2
R10 1.71 × 106 1.31 × 103 1,305 3 4.50 × 102 1.02 × 105 441 2
R11 1.15 × 106 1.08 × 103 1,065 3 8.94 × 102 6.72 × 104 1,330 3
R12 1.39 × 105 8.85 × 102 157 2 4.70 × 103 6.33 × 104 7,425 3
R13 3.45 × 105 9.42 × 102 366 2 9.44 × 101 8.59 × 104 110 2
R14 6.62 × 103 5.55 × 102 12 1 5.37 × 103 6.98 × 104 7,693 3
R15 1.85 × 104 9.14 × 102 20 1 1.74 × 103 9.09 × 104 1,914 3
R16 1.40 × 104 8.20 × 102 17 1 4.14 × 103 1.03 × 105 4,019 3
R17 2.92 × 104 8.58 × 102 34 1 2.67 × 103 6.54 × 104 4,083 3
R18 1.93 × 104 8.04 × 102 24 1 3.18 × 103 8.22 × 104 3,869 3
R19 3.05 × 104 6.46 × 102 47 1 2.56 × 103 6.00 × 104 4,267 3
R20 5.16 × 104 6.81 × 102 76 1 2.92 × 103 5.92 × 104 4,932 3
R21 1.50 × 104 5.82 × 102 26 1 3.18 × 103 8.53 × 104 3,728 3
R22
 5.27 × 105
 5.88 × 102
 896
 2
 2.12 × 101
 4.57 × 104
 46
 1
LUL
 L1 5.44 × 106 1.52 × 103 3,579 3 UDL 7.39 × 104 UDL 0
L2 1.34 × 106 1.91 × 103 702 2 6.85 × 101 1.20 × 105 57 1
L3 6.73 × 105 1.78 × 103 378 2 UDL 6.16 × 104 UDL 0
L4 1.52 × 105 1.36 × 103 112 2 2.00 × 101 8.92 × 104 22 1
L5 9.59 × 105 1.83 × 103 524 2 UDL 4.99 × 104 UDL 0
L6 1.59 × 105 1.33 × 103 120 2 3.13 × 102 4.26 × 104 735 2
L7 3.85 × 106 1.94 × 103 1,985 3 1.50 × 101 6.69 × 104 22 1
L8 1.77 × 106 2.36 × 103 750 2 UDL 5.40 × 104 UDL 0
L9 1.02 × 106 1.37 × 103 745 2 UDL 4.96 × 104 UDL 0
L10
 3.11 × 106
 2.22 × 103
 1,401
 3
 UDL
 6.25 × 104
 UDL
 0
LLL L11 1.27 × 105 1.07 × 103 119 2 5.54 × 102 4.49 × 104 1,234 3
L12 3.80 × 104 8.48 × 102 45 1 6.42 × 103 1.12 × 105 5,732 3
L13 2.16 × 104 7.91 × 102 27 1 5.91 × 103 8.87 × 104 6,663 3
L14 4.87 × 104 8.73 × 102 56 1 2.85 × 103 7.76 × 104 3,673 3
L15 4.65 × 104 1.22 × 103 38 1 4.08 × 103 6.36 × 104 6,415 3
L16 2.86 × 104 8.88 × 102 32 1 5.68 × 103 6.80 × 104 8,353 3
L17 3.42 × 104 9.42 × 102 36 1 3.58 × 103 6.45 × 104 5,550 3
L18 3.89 × 104 9.47 × 102 41 1 4.64 × 103 6.87 × 104 6,754 3
L19 4.25 × 103 5.81 × 102 7 1 5.82 × 102 1.02 × 105 571 2
L20 1.56 × 104 8.09 × 102 19 1 6.10 × 101 9.11 × 104 67 1

*ACTB, β-actin; GAPDH, glyceraldehyde 3-phosphate dehydrogenase; LLL, left lower lobe; LUL, left upper lobe; RLL, right lower lobe; RUL, right upper lobe; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; UDL, under detection limit.
†SARS-CoV-2-RNA score is as follows: score 1, SARS-CoV-2 RNA/GAPDH mRNA ratio<100; score 2, 100–1,000; score 3, 1,000–10,000.
‡S. pneumoniae DNA score is as follows: score 1, S. pneumoniae DNA/ ACTB DNA ratio × 105 <100; score 2, 100–1,000; score 3, 1,000–10,000. 
§Lung sections R1–R22 and L1–L20) are shown in Figure 1.

Main Article

1These authors contributed equally to this article.

Page created: January 06, 2021
Page updated: February 21, 2021
Page reviewed: February 21, 2021
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